Table 2.

Summary of qualitative studies.

Author, Year, Location	Eligibility Criteria	Sample Size	Male/Female	Age (Years)	Time Since Bereavement	Relationship to Deceased	Setting	Study Design	Main Results
Adams et al. (2019) AUS [14]	Bereaved by suicide of sibling (sibling <20 y/o) in past 10 yrs	N = 7	M = 4 F = 3	20–27 at time of interview (16–23 at time of suicide)	Average time = 3 y 9 m	Sibling	Telephone interview	Interpretive phenomen-ological analysis (IPA)	Identified 4 main themes: (a) the process of grief, (b) grief interactions (within families and outside), (c) continuing bonds, and (d) meaning-making and growth through grief.
Bailey et al. (2015) UK [21]	Family members and friends who own suicide memorial sites	N = 11	M = 3 F = 8	20–60	5 m–4 y	Parent, siblings or friends	Face-to-face interviews—semi-structured narrative style	Qualitative interpretative approach, combining constant comparison techniques with thematic analysis	The most common motivating factor for starting a memorial page was to ‘keep the deceased alive’ and maintain a connection. Participants found that they were able to better construct and refine relationships with the deceased using online memorials. Whilst most people had positive experiences with memorial sites, the dangers of becoming overly attached and experiencing compounding grief or ‘double loss’ was highlighted.
Bell et al. (2015) UK [22]	Individuals who had set up or were managing memorial sites for those who dies by suicide	N = 11	M = 3 F = 8	20–60	5 m–4 y	Parent, siblings or friends	Individual interviews	Qualitative interpretative approach, combining constant comparison techniques with thematic analysis	Provided insight into how online memorialisation allows more flexibility and depth in the exploration of grief than can traditional mourning objects—this allows users to reminisce on positive aspects of deceased life but can elicit negative experiences as users can’t control how memories are framed.
Castelli Dransart (2018) Switzerland [27]	Suicide-survivors: A person was considered as a survivor of suicide if: (1) he/she self-qualified as such; (2) he/she felt emotionally close to the deceased; and (3) his/her life had been disrupted by a suicide (self-perception). >18 y/o, able to speak Italian, French or German	N = 50	M = 11 F = 39	14–73	<12 m–16 y	18 mothers, 5 fathers, 10 sisters, 3 brothers, 3 daughters, 1 son, 7 partners, 1 aunt, 2 friends	Face-to-face in depth interviews conducted by author or mental health carer, either at home or location chosen by bereaved	Grounded Theory using constant comparison of data and 3 steps of coding: open, axial & selective	Suicide triggered spiritual and religious thoughts and experiences for most participants. Even those who claimed to be atheist or agnostic noted religious rituals and spiritual symbols as being important contributors in forging and maintaining a continuing bond with the deceased and in honouring their memory. Interviewees believed loved ones continued to exist in an alternative dimension or space (regardless of religion).
Entilli et al. (2021) AUS [15]	Parents who had lost a child by suicide less than 6 months prior to starting the study	N = 14 at 6 and 12 months. N = 11 at 24 months	M = 7 F = 7 (6 and 12 months). M = 6 F = 5 (at 24 months)	Female mean = 60.1 years, range = 50–78 years and male mean = 59.9 years, range = 50–68 years	6 m, 12 m and 24 m	Parents who had lost a child (aged 15–51) by suicide. Ten were bereaved of sons and four bereaved of daughters	Semi-structured interviews either phone or face-to-face	Longitudinal study using thematic analysis	Three key themes were identified in an earlier analysis (at 6 and 12 months post loss): searching for answers and sense-making, coping strategies and support, and finding meaning and purpose. Further exploration of these themes at 24 months revealed significant differences between mothers and fathers with the latter adopting more maladaptive coping strategies. Maintaining the relationship with the deceased and paranormal experiences were new themes at 24 months (not present at 6 and 12 months) and a shift from brooding to reflection/sense-making was seen at 24 months. The adaptation process was fluctuating and dynamic.
Gall et al. (2015) Canada [26]	Individuals who had personal experiences of suicide bereavement	N = 15 (11 bereaved and 4 mental health workers)	M = 2 F = 9 (bereaved) M = 1 F = 3 (MHW)	Mean age was 49 (bereaved) and 53 (MHW)	Mean = 13 y, minimum of 2 y	The deceased persons were: four sons, two fathers, two close friends, two uncles and one mother.	Semi-structured interviews	Phenomenological approach, thematic analysis	Individuals had difficulty reconciling the suicide death of a loved one with their religious views. This often led to a personally defined spirituality rather than a complete loss of faith. Many individuals (also non-religious) found meaning in the belief of an afterlife and/or felt hopeful that the deceased was in a better place and would someday reconnect with them. Engagement in activities to maintain a bond were common.
Hunt et al. (2019) USA [9]	>18 y/o, self-identified as suicide loss survivor, >5 years since death	N = 10	M = 6 F = 4	30–72 (mean = 47.6)	5 y–30 y (mean = 18.6 y)	5 siblings, 2 partners, 2 parents and one participant who had lost a sibling, grandfather and cousin	Face-to-face semi-structured interviews at participants homes	Thematic analysis informed by grounded theory	Three major themes were identified: -one harmful (feelings of responsibility) -one helpful (making meaning) to the process of suicide bereavement. -one that helped shift from harmful to helpful (social support) Participants did not identify with the Kubler-Ross stages of grief theory.
Jahn et al. (2018) USA [20]	Any person who identified as bereaved by suicide	N = 1301	M = 135 F = 1155 U = 11	40–85	1 y–3 y (28.9%; n = 376), <1 y (25.7%; n = 334), 4 y–10 y (22.0%; n = 286), 11 y–20 y (12.2%; n = 159), and >20 y (8.2%; n = 107).	Anyone bereaved by suicide	Two questionnaires—one demographics and one about spiritual experiences after suicide bereavement. Both containing both qualitative and quantitative info	Inductive thematic analysis	Nine main themes were identified: (1) a helpful sense of comfort; (2) a helpful sense of connection with the deceased; (3) intense sadness evoked by the spiritual experiences; (4) confusion regarding the spiritual experiences; (5) negative reminders of the deceased or negative meanings of spiritual experiences; (6) evidence of an afterlife; (7) general importance of the spiritual experiences’ meaning; (8) impact of and on religious beliefs; and (9) others’ responses to disclosure of suicide or spiritual experiences. Generally, participants found spiritual experiences aided in healing and transformation and were regarded as positive.
Leichtentritt et al. (2015) Israel [25]	Having experienced the loss of a sibling to suicide and the death having occurred at least five years prior to the interview	N = 9	M = 3 F = 6	29–63	5 y–37 y	Sibling	In-depth interviews	Relational dialect theory and narrative analysis used.	Five characteristics of the post death relationship were identified, each existing along a continuum: (1) concrete-symbolic (2) dynamic-static (3) conscious-unconscious (4) personal-public (5) monologue-dialogue Findings suggest that labelling post death relationships as ‘adaptive’ or ‘maladaptive’ is simplistic. Bereavement can be better understood when plotted within the 5 continua.
Maple et al. (2013) AUS [16]	Parents who lost a child by suicide	N = 22	M = 6 F = 16	NA	6 m–>26 y	22 parents (6 fathers and 16 mothers) from 18 families bereaved of 15 sons and 3 daughters. 14 participated individually and 4 as couples	In-depth interviews, mostly face-to-face (one phone)	Narrative Inquiry, recursive technique used to explore in more depth.	Contrary to traditional grief literature, it was found that parents needed to maintain a relationship with their deceased child. Manifestations of continuing bonds varied between parents. Commencing with the funeral, parents began developing rituals ensuring that their child’s life, and not the manner of death, was celebrated. Some participants were limited in their expression of grief due to social pressure to resolve grief.
Ross et al. (2018) AUS [17]	Parents bereaved by suicide loss of their child 6 months prior to commencement of study	N = 14	M = 7 F = 7	50–78 (female mean = 60.1 years and range = 50–78, male mean = 59.9 years and range = 50–68)	6 m and 12 m	Parents who had lost a child (aged 15–51) by suicide. Ten were bereaved of sons and four bereaved of daughters	Individual, semi-structured interviews either face-to-face or telephone	Longitudinal study with inductive qualitative approach.	Identified three key themes (searching for answers and sense-making, coping strategies and support, and finding meaning and purpose) in parental responses to suicide bereavement. The phases of sense-making and meaning-making experienced by participants and the range of both adaptive and maladaptive coping strategies indicated that adapting to bereavement is a dynamic and fluctuating process.
Sands et al. (2010) AUS [18]	Adults >19 y/o, bereaved through the suicide death of a significant person in their lives	N = 16	NA	Aged 19+	>2 m	Family members or spouses: partner grieving a partner, parent grieving a child, sibling grieving a sibling, and adult child grieving a parent	A series of workshops delivered over 12 weeks and 30 h–involved discussion, artwork, grief rituals and journal writing	Generic thematic analysis	Identified 3 core themes that assisted in meaning making in relationships with the themselves, the deceased, and with others. The 3 themes were: (i) Intentionality (‘tying on the shoes’ or adopting the perspective of the deceased), (ii) Reconstruction (‘walking in the shoes’), (iii) Repositioning (‘taking off the shoes’)
Wood et al. (2012) UK [23]	8–15 y/o (M = 11.80, SD = 2.57), whose parent had died by suicide within the previous 13 to 53 months	N = 10	M = 5 F = 5	8–15	13 m–53 m (M = 33.4, SD = 17.44)	Eight children bereaved of a father and two bereaved of a mother	Semi-structured interviews, face-to-face at participants’ homes	Interpretative Phenomen-ological Analysis	Found 3 main themes: thinking about the deceased; coping strategies; and connecting to the deceased. Highlighted differences in childhood suicide bereavement as well as factors which may influence adaptiveness.